Coronary artery disease usually is diagnosed after a person has chest pain or other symptoms.
Your doctor will examine you, paying special attention to your chest and heart. Your doctor will press on your chest to see if it is tender. Tenderness could be a sign of a non-cardiac problem. Your doctor will use a stethoscope to listen for any abnormal heart sounds.
Your doctor will do one or more diagnostic tests to look for CAD. Possible tests include:
An EKG. An EKG is a record of the heart's electrical impulses. It can identify problems in heart rate and rhythm. It can also provide clues that part of your heart muscle isn't getting enough blood.
Blood test for heart enzymes. Damaged heart muscle releases enzymes into the bloodstream. Elevated heart enzymes suggest a heart problem.
An exercise stress test. This test monitors the effects of treadmill exercise on blood pressure and EKG to identify heart problems.
An echocardiogram. This test uses ultrasound to produce images of the heart's movement with each beat.
Imaging test with radioactive tracers. In this test, a radioactive material helps certain features of the heart show up on images taken with special cameras.
A coronary angiogram. This is a series of X-rays of the coronary arteries. The coronary angiogram is the most accurate way to measure the severity of coronary disease.
During an angiogram, a thin, long, flexible tube (catheter) is inserted into an artery in the forearm or groin. The tip of the tube is pushed up the body's main artery until it reaches the heart. Then it is pushed into the coronary arteries. Dye is injected to show blood flow within the coronary arteries. It also identifies any areas of narrowing or blockage.
Angiography can now also be performed with a CT scan of the chest. It is done while dye is injected in a vein. The newer process is called CT angiography.